Beverages a Growing Source of Calories in Mexico

Originally published in Food, Nutrition & Science.

Women and children in Mexico are continuing to increase their consumption of sugar-sweetened, caloric beverages, according to a recent study from The University of North Carolina at Chapel Hill (UNC) and the National Institute of Public Health in Cuernavaca, Morelos, Mexico.

A tax on sugar-sweetened beverages (SSB) in Mexico was put in place in January 2014. In order to evaluate the effectiveness of this type of tax, researchers needed to describe the consumption of these types of beverages in the Mexican population before the implementation of the tax. Researchers looked at a two nationally representative surveys, calculating the volume and energy intake per capita and per consumer, and the proportion of consumers of each beverage group in each survey. They looked at differences over time for age subgroups where they had information, described beverage consumption in more details for all age-gender groups and looked at sales trends.

Overall, total energy intake increased for the groups researchers looked at (children and women of reproductive age). They found that from 1999 to 2012, total daily energy from beverages increased among children aged 5 to 11 by 45.3 kcal, among females aged 12 to 19 by 57.3 kcal and among adult females aged 20 to 29 by 96.4 kcal.

“The expectation is that the implementation of a tax on SSB will result in a reduction in sales and therefore, consumption of SSB. Other initiatives have been put in place to simultaneously decrease consumption of SSB, such as banning the sale of sodas from schools. Therefore, all these efforts will need to be taken into account when evaluating the effect of the tax,” says study co-author Dalia Stern, a PhD candidate at UNC.

Worrisome is the fact that in 2012, beverages represented 17.5% (325 kcal) and 19.0% (382 kcal) of the total daily energy intake per capita in children aged 1 to 19 and in adults over the age of 20, respectively. The three biggest contributors to the per capita total energy intake in adults over the age of 20 were caloric soda (4.7%), calorie coffee/tea (3.5%) and “agua fresca” (fruit waters) (2.4%).

“Traditionally, Mexicans have consumed mainly ‘aguas frescas’ (home-made fruit and sugar-flavored waters). These beverages were usually consumed both at home and also from street vendors. As Mexico undergoes a transition into modernization, a wide range of commercially prepared ‘aguas frescas’ as well as new SSBs are being introduced in the marketplace. One of the possible consequences of such changes is an increased intake of added sugars and calories, as these commercially prepared SSBs are much higher in sugar than traditionally home-made flavored waters. Moreover, it is well known that Mexico is the top per capita consumer of soda, and over the 1999-2012 period, we observed an increase in the trend of sales of regular soda. We also observed an increase in sales of fruit-flavored drinks, flavored bottled waters and juice drinks. Taken together, these may have contributed to the increase in SSBs,” says Stern.

Over the past seven years, Mexico has put in place a number of programs to help curb rising obesity rates, as Mexico has one of the highest rates in the world of both childhood and adults overweight and obesity. Unfortunately, though, the January 10% excise tax on any beverage containing added sugars, with the exception of milk, was lower than research had advocated. A 20% tax would have been preferred, and so it is unclear if the 10% tax will be enough of a deterrent. Important too is what beverages consumers will choose to substitute for sugar-sweetened beverages.

“The implementation of the tax is only one of many strategies of the Mexican government’s effort to curb its obesity epidemic. Short and long-term evaluations on whether the implementation of the tax (together with other strategies) reduce SSB sales and consumption will be key. Additionally, it is important to conduct long-term evaluations to determine if these strategies help in reducing the BMI of the Mexican population and the incidence of nutrition and obesity related diseases, as well as the health care cost designated to nutrition and obesity related diseases,” says Stern.